Individual
DIANA KOPPUZHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
20389 INTERSTATE 35 STE 200, KYLE, TX 78640-2039
(512) 256-8754
Mailing address
20389 INTERSTATE 35 STE 200, KYLE, TX 78640-2039
(512) 256-8754
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
33222
TX
Other
Enumeration date
03/18/2016
Last updated
07/21/2022
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